MEDICARE: FRIENDS FOR LIFE REHABILITATION SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295463453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIENDS FOR LIFE REHABILITATION SERVICES

Provider Business Mailing Address
First Line	:	2908 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115-2416
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2908 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115-2416
Country	:	US
Telephone Number	:	216-600-9181
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	OMAR KURDI
Credential	:
Telephone Number	:	216-600-9181

Provider Enumeration Date	:	08/15/2022
Last Update Date	:	08/15/2022

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